Cancer Vaccine

Sometimes, rarely, miracles really do happen. Sometimes, a cancer patient is at deaths door, riddled with deadly metastatic melanoma, when they spontaneously get better. Their own body fights off the disease without drugs or radiation. And it's made scientists to wonder - is it possible to trigger the body's power to heal itself? Now, two Australian research groups think they can. This is the inspiring story of their quest to create miracles on tap.

Broadcast:
Thu 14 Oct 2004, 8:00pm

Published:
Thu 14 Oct 2004, 8:00pm

Transcript

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Narration

Can miracles happen?

Suzanne's body was riddled with lumps of deadly skin cancer - malignant melanoma. Then suddenly, without any treatment, she got better.

Suzanne

They were everywhere, the base of my neck, across my shoulders. One was discovered in my brain...

A. Prof Jonathon Cebon

So here's an extraordinary case. This is a cancer, a melanoma secondary in the middle of (this woman's) liver, and six months later its completely gone with no treatment.

Narration

Her own body had spontaneously fought off the disease.

A. Prof Jonathon Cebon

Yeah truly miraculous. Truly miraculous.

Narration

Spontaneous remission happens, but rarely. Around the world researchers wonder - can we trigger the body's extraordinary power to heal itself?

That's the dream of immunotherapy.

Cancer, in effect, is a collection of rogue cells, that manage to evade our body's internal police force ... the immune system.

Our immune system has specialised cells which detect invaders - like viruses and germs - and kill them.

But cancer is not an invader - it's a traitor... the body's own cells multiplying out of control.

A. Prof Jonathon Cebon

Now the reality is that those rogue cells are very similar to the cells that gave birth to them.

So there's a huge challenge for the immune system to recognise cells which are almost identical to their counterparts.

Narration

So cancers can hide. Unseen and unchecked, they multiply and grow.

If only we could expose the rogue cells to the immune system - - and use our own bodies resources to fight cancer?

Dr Chris Schmidt

We think actually the hope is much beyond simply suppressing the cancer. We think that ultimately the goal is to completely eradicate the tumour so it never comes back

This kind of immune therapy was first suggested more than 50 years ago.

But after decades of disappointing research, most experts - like former immunologist Professor Alan Coates - became disillusioned.

Professor Alan Coats

I really thought that it was likely to bring an answer to treating cancers by immunological means in my lifetime. Then when I came to realise that was most unlikely to happen in my lifetime I stayed with the cancer and left the study of immunology to others.

Narration

But today, a new generation of scientists are once more pursuing the immunotherapy dream - immunologists like Chris Shmidt.

What revived his faith? The potential of these amazing immune cells - called dendritic cells.

Dr Chris Schmidt

They're fantastic aren't they. Amazing images you can get of them.

Narration

Dendritic scan the body, looking for invaders like germs - then telling the immune system what to kill.

Dr Chris Schmidt

They're role is to educate the immune system: If you like, they put out a most wanted poster on those invaders.

Narration

So could dendritic cells also be taught to expose the traitors - cancer?

Chris's team attempted something no one had tried.

They took the patients own tumour - and the patients own dendritic cells - and forced them to meet.

Dr Chris Schmidt

And there you can actually see part of a melanoma cell, part of the patient's own melanoma cells that have been eaten up by the dendritic cell.

Jonica Newby, reporter

That's that big black dot there is it?

Dr Chris Schmidt

That's right, yes.

Jonica Newby, reporter

So this is a dendritic cell that's ready to teach the immune system that there's something wrong, melanoma.

Narration

Artificially loaded up, the dendritic cells were then injected back into patients.

The question was, would they spread the message - teaching the immune system to kill cancer?

For several years, a group of melanoma patients received regular doses. Most showed no benefit.

But in a small percentage of cases, one in ten, remarkably, the tumours began to disappear.

Dr Chris Schmidt

Current therapies that are used very seldom result in durable complete remission of disease. So since we've seen a number of patients who have got rid of all signs of their disease and they remain free of disease, I think that's an extraordinary achievement.

Narration

As promising as it seems, though, there is a problem with this personalised treatment.

Professor Alan Coats

It takes a lot of resources, very careful and expensive laboratory work to produce, a single treatment. That's not the same as producing one drug which can then be mass produced and given to lots of people.

Narration

But immunotherapy on mass is what another research group are chasing here in Melbourne.

Jonathon Cebon and his team are onto a weak point in cancer's disguise.

They've found a marker - a telltale feature that allows cancers to be distinguished from other cells.

A. Prof Jonathon Cebon

Okay, so this is a melanoma, and you can see that there are these islands of cells. They're the cancer cells, the melanoma cells, and they're all bright red.

Jonica Newby, reporter

It's really clear isn't it.

A. Prof Jonathon Cebon

And the reason that they're red is because they contain this molecule called NY-ESO-1

Narration

The NY-ESO-1 protein was discovered by Jonathon's colleagues in New York. It's found on a variety of cancers, from melanoma to lung cancer.

A. Prof Jonathon Cebon

It was a fantastic discovery because it provides an Achilles heel if you like. It's something which sets one cell apart from the other and enables you to potentially attack the cancer cells without normal cells of the body being harmed.

Narration

And that opened up an exciting possibility.

Inside this facility, they're growing the protein, purifying it, and putting it into vials

Their purpose? To create a substance which could teach immune systems how to spot - and fight - cancer - on a mass scale.

They're making a vaccine - not to prevent, but to treat cancer.

A. Prof Jonathon Cebon

So this is the final vaccine ready to give to patients.

Narration

But does it work? Four years ago, they began a small trial in patients - also with melanoma.

All participants had conventional surgery, whilst some also received the vaccine.

They weren't actually looking to see whether it was effective, just to see if it was safe.

Stewart, who was diagnosed with malignant melanoma four years ago, was on that trial.

A. Prof Jonathon Cebon

So I think we can be satisfied you remain clear of disease.

Stewart

Great.

Narration

Today, most of those who got the vaccine, like Stewart, remain alive and disease free .

Most who didn't get the vaccine have had their disease return - some have since died.

Stewart

I really, the old heart missed a beat and the old saying, there but for the grace of God. God I is really relevent in those situations. So I just feel so thankful.

A. Prof Jonathon Cebon

I think it's enormously promising from the point of view of what we've seen at the immune level. I think we've got a tantalising suggestion that it may be helpful at a clinical level. But the only real way of finding out if it's promising is to do the trial and get the answer. And we're setting up to do that next clinical trial now.

Narration

So is this it? Are we on the verge of achieving the dream - harnessing the immune system to create miracles?

Professor Alan Coats

Nobody would be happier than I if this one is it but it's yet to be proven and caution would have to remind me that all the ones that have looked good in the past have not delivered.

Dr Chris Schmidt

I think the important thing about what we've achieved is that it makes it clear that the immune system really can fight cancer.

A. Prof Jonathon Cebon

Miracles are certainly happening. I mean, examples like Suzanne you know shine at us. And I think we're now much closer to understanding why those miracles take place.